[GiraffeNecktie]

I don't see that shutting down the FDA is a good alternative. There are countless therapies that are dangerous and/or ineffective and plenty of unscrupulous or incompetent people who want to flog them. Yes there's a human cost to regulation, but that's nothing compared to the cost of opening the floodgates to every half-baked idea out there, not to mention the damage to medical science when the medical trials are bypassed.

[Gormo]

> There are countless therapies that are dangerous and/or ineffective and plenty of unscrupulous or incompetent people who want to flog them.

There are countless regulatory policies that are dangerous and/or ineffective and plenty of unscrupulous or incompetent politicians who want to flog them.

So what process validates the "safety" and "effectiveness" of the FDA's universal-scope regulations? Certainly, given that you and I can't opt out of them as we can with drugs and medical procedures, the danger of bad policy can be far graver than the danger of bad medicine, yet there's no regulation of regulatory policy at all!

I understand the desire to protect people from fraud and deceit, especially when the consequences of bad medicine are literally life-or-death, but surely the proper way to accomplish this end is to supply people with the data that will allow them to make informed decisions, rather than usurping their right make decisions in the first place.

The FDA should function as a certification body, evaluating drugs and treatments, and informing patients as to the likely results of using each, but it should not have the power to prohibit anyone from undergoing any treatment or taking any drug.

[GiraffeNecktie]

Sounds good in theory but I don't think the average doctor, let alone the average patient, is capable of independently weighing the pros and cons of every novel treatment. And then you have desperately people who might normally be more skeptical but will believe just about anything in the pain and torment of a moment when they or a loved one falls ill.

No thanks. I'll take the imperfect regulation over the "free market" any day.

[Gormo]

> Sounds good in theory but I don't think the average doctor, let alone the average patient, is capable of independently weighing the pros and cons of every novel treatment

Why not? Who else can be more qualified to weigh the pros and cons of a novel treatment than the patient himself? What we're talking about here is the act of applying one's own value system to the likely distribution of results associated with that treatment. If the patient is properly informed of the latter data, then the remaining variable is the set of personal risk-reward value judgments that only the patient himself has access to. If the patient is not properly informed of the relevant data, well, then, why isn't he?

If the patient himself isn't capable of weighing the options, and neither is the doctor, that means that even more remote people who aren't familiar with the particulars of the case at hand, are going to be less likely, not more likely, to make a good decision. You're going in the wrong direction here.

> And then you have desperately people who might normally be more skeptical but will believe just about anything if they or a loved one fall ill.

Right. This is part of the point that I'm making; people who are "desparate" because they're literally in life-or-death situations will tend to have a much more idiosyncratic and organic hierarchy of risk-reward tradeoffs that isn't likely to be captured by generalized presumptions. You're trying to cast "desperation" as a impediment to informed decision-making, when in reality, "desparation" displays the underlying priorities of the patient in much clearer relief than comparative indifference ever could. People are desperate precisely because of the drastic implications of the situation, which means that it's much more important for the patient to make a choice compatible with his underlying value system than it would be in other, less impactful situations.

It's not a question of people being willing to "believe just about anything" to alleviate a horrific illness; it's their willingness to try even remote options, because even a tiny chance is better than none that you're not giving due consideration to.

> I'll take the imperfect regulation over the "free market" any day.

It's not about a "free market" as much as it's about your individual freedom to determine the disposition of your own life and health

Of course, if you'd rather trust one group of third parties over both another group of third parties and your own judgment, that's your prerogative. If the FDA were merely a certification group, you'd still have the option of relying only on that FDA certification as your sole decision criterion, and not considering the matter any more deeply than that. But you've got absolutely no right to demand that others outsource their own value judgments to your preferred third parties.

[n3rdy]

> There are countless therapies that are dangerous and/or ineffective and plenty of unscrupulous or incompetent people who want to flog them.

The FDA forces their own therapy of "do nothing for yourself" on the patient when the patient has run out of options. If something costs me my life, I don't care if something else would have cost me my fortune. At least my right to defend my own life would not have been infringed on by the FDA.

[CamperBob2]

The problem is, an entire industry would spring up to do nothing but separate the dying from their fortunes. We already have churches for that. The FDA is all that stands in the way of an equally massive industry of snake-oil sellers.

The problem is, people want to believe. That's a bug in our mental firmware. The FDA is an ugly, flawed, but arguably vital workaround for that bug. If you want to get rid of it, you need to offer another fix for the bug.

[n3rdy]

> The FDA is an ugly, flawed, but arguably vital workaround for that bug. If you want to get rid of it, you need to offer another fix for the bug.

Here is an idea of a work around.

First, FDA "recommendations" shouldn't be mandatory. Even things the FDA claims to be safe can be more harmful than some of the things that it warns are unsafe.

Second, There should be competing private agencies other than just the FDA. Their reputations would rely on how safe their "approved" medication and procedures turn out to be.

Third, A patient looking for a treatment should be able to look up the ratings of doctors, medications, procedures. If they find a potential scam artists, they will see the negative reviews and reports of patients who died under their care. They will have valuable information to make their medical decisions that they don't have today. The ratings and information would be maintained by private agencies and the FDA. Kind of like a credit score for doctors, medications, and medical procedures.

This obviously doesn't solve every single problem, but I think its a pretty good start.